Effects of the estrogenicity of levonorgestrel/ethinylestradiol combinations of the lipoprotein status.
Ninety-eight women seeking contraceptive advice were randomly allocated to 6 months of treatment with one of the following four combinations of ethinylestradiol (EE) and levonorgestrel (NG): 20/250, 30/250, 30/150, and the so-called triphasic drug. The EE/NG ratios were 0.08, 0.12, 0.20 and 0.36 respectively. Blood lipids, HDL-cholesterol and sex hormone binding globulin (SHBG) were determined twice before treatment and after 1, 3 and 6 months of medication. Plasma triglyceride levels were moderately elevated in all groups, with the highest increase in the women taking the triphasic drug. The HDL-cholesterol and HDL-cholesterol to cholesterol ratios were both markedly reduced, by 20/250 and 30/250, while 30/150 and the triphasic drug caused only minor reductions. The mean change in HDL-cholesterol showed a good correlation with the mean changes of SHBG (r = 0.916) and with the EE/NG ratios (r = 0.979). It is concluded that both SHBG and the EE/NG ratio may be used as an index of the estrogenicity of a combined oral contraceptive drug. As reduced HDL-cholestrol levels and HDL-cholesterol to cholesterol ratios have been shown to be directly correlated to the risk of developing ischemic cardiovascular disease it would seem important that the estrogenicity of such a drug should be sufficiently high.
D002784:Cholesterol / Q000097:blood; D002986:Clinical Trials as Topic; D003276:Contraceptives, Oral / Q000009:adverse effects*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D003280:Contraceptives, Oral, Synthetic / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016912:Levonorgestrel; D008074:Lipoproteins / Q000097:blood*; D009644:Norgestrel / Q000009:adverse effects*; D010743:Phospholipids / Q000097:blood; D011897:Random Allocation; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D014280:Triglycerides / Q000097:blood
D003276:Contraceptives, Oral; D003277:Contraceptives, Oral, Combined; D003280:Contraceptives, Oral, Synthetic; D008074:Lipoproteins; D010743:Phospholipids; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D009644:Norgestrel; D004997:Ethinyl Estradiol; D016912:Levonorgestrel; D002784:Cholesterol